Specialty-associated differences in intensive care unit rotation exit examination performance: a single-center retrospective cross-sectional study.
4 affiliations
- 1Wenzhou Medical University, Wenzhou, China.
- 2The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
- 3Wenzhou Medical University Renji College, Wenzhou, China.
- 4The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Abstract
Background
Intensive care unit (ICU) rotations bring together residents from multiple specialties. Comparisons of exit performance may be distorted when departments differ in postgraduate-year (PGY) composition and when non-equivalent examination forms are used across PGY levels.Methods
We conducted a retrospective cross-sectional analysis of ICU exit examination records from 412 residents at a tertiary teaching hospital in China between November 2025 and April 2026. Three 100-item, 60-min examinations containing four question types were administered according to PGY. Departmental differences were evaluated using four complementary strategies: a same-examination subgroup of 227 PGY-2 residents, within-examination standardization, analysis of covariance adjusting for the combined PGY/form grouping, and hierarchical regression. Item characteristics, version-specific reliability, and exploratory differential item functioning were assessed retrospectively.Results
In the same-examination subgroup, the total-score effect size was η ² = 0.098 (p < 0.001), with surgery having the lowest mean score (75.9; SD 9.1; n = 77; 95% CI 73.9-78.0). Department explained an additional 7.6% of total-score variance after adjustment for PGY/form. The descriptive attenuation ratio was 21.3% for total scores, ranging from 7.3% for case-series items to 80.2% for basic-knowledge items. These ratios do not identify separate training-year or examination-version effects. The largest negative case-analysis gaps occurred in surgery and anesthesiology.Conclusion
Specialty-associated differences in examination performance were observed within this single-center educational setting and using this assessment instrument. The absence of baseline scores and incomplete evidence of cross-form comparability preclude causal or inherent-specialty interpretations; prospective baseline-controlled studies are needed before specialty-tailored interventions are adopted.
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BibTeX
@article{lu2026specialtyassociated,
title = {{Specialty-associated differences in intensive care unit rotation exit examination performance: a single-center retrospective cross-sectional study.}},
author = {Yanche Lu and Ruijie Lin and Qian Yu and Qiuyu Zheng and Lianmin Ye},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1960270},
url = {https://europepmc.org/article/MED/42908821},
note = {CC BY},
}
RIS
TY - JOUR
TI - Specialty-associated differences in intensive care unit rotation exit examination performance: a single-center retrospective cross-sectional study.
AU - Yanche Lu
AU - Ruijie Lin
AU - Qian Yu
AU - Qiuyu Zheng
AU - Lianmin Ye
PY - 2026
DA - 2026/10/07
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1960270
UR - https://europepmc.org/article/MED/42908821
AB - Background Intensive care unit (ICU) rotations bring together residents from multiple specialties. Comparisons of exit performance may be distorted when departments differ in postgraduate-year (PGY) composition and when non-equivalent examination forms are used across PGY levels.Methods We conducted a retrospective cross-sectional analysis of ICU exit examination records from 412 residents at a tertiary teaching hospital in China between November 2025 and April 2026. Three 100-item, 60-min examinations containing four question types were administered according to PGY. Departmental differences were evaluated using four complementary strategies: a same-examination subgroup of 227 PGY-2 residents, within-examination standardization, analysis of covariance adjusting for the combined PGY/form grouping, and hierarchical regression. Item characteristics, version-specific reliability, and exploratory differential item functioning were assessed retrospectively.Results In the same-examination subgroup, the total-score effect size was η ² = 0.098 (p < 0.001), with surgery having the lowest mean score (75.9; SD 9.1; n = 77; 95% CI 73.9-78.0). Department explained an additional 7.6% of total-score variance after adjustment for PGY/form. The descriptive attenuation ratio was 21.3% for total scores, ranging from 7.3% for case-series items to 80.2% for basic-knowledge items. These ratios do not identify separate training-year or examination-version effects. The largest negative case-analysis gaps occurred in surgery and anesthesiology.Conclusion Specialty-associated differences in examination performance were observed within this single-center educational setting and using this assessment instrument. The absence of baseline scores and incomplete evidence of cross-form comparability preclude causal or inherent-specialty interpretations; prospective baseline-controlled studies are needed before specialty-tailored interventions are adopted.
SN - 2296-858X
ER -